Provider Demographics
NPI:1467692459
Name:BERRYHILL, INDIA JEANEICE (CRNP)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:JEANEICE
Last Name:BERRYHILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35502-0708
Mailing Address - Country:US
Mailing Address - Phone:205-387-2253
Mailing Address - Fax:205-387-2405
Practice Address - Street 1:3909 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2838
Practice Address - Country:US
Practice Address - Phone:205-333-1993
Practice Address - Fax:205-333-0293
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-078439363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner